-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, J947q/EJrnpuCPVpFf5+uJsA9V70Azt9FLRCGN+8498vZpAjsxthZLIHHZ7gr6Hx wxVnVxe/nOtpaWzrh4YHQg== 0000064670-02-000121.txt : 20021028 0000064670-02-000121.hdr.sgml : 20021028 20021028142523 ACCESSION NUMBER: 0000064670-02-000121 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20021024 FILED AS OF DATE: 20021028 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MEDTRONIC INC CENTRAL INDEX KEY: 0000064670 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 410793183 STATE OF INCORPORATION: MN FISCAL YEAR END: 0430 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07707 FILM NUMBER: 02799712 BUSINESS ADDRESS: STREET 1: 710 MEDTRONIC PKWY STREET 2: MS LC300 CITY: MINNEAPOLIS STATE: MN ZIP: 55432 BUSINESS PHONE: 7635144000 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: BALAGNA JEFFREY A CENTRAL INDEX KEY: 0001145145 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 710 MEDTRONIC PKWY MS LC310 CITY: MINNEAPOLIS STATE: MN ZIP: 55432-5604 BUSINESS PHONE: 7635144000 4 1 balagna102402form4.txt JEFFREY BALAGNA 10/24/02 FORM 4 1. Name and Address of Reporting Person Balagna, Jeffrey Medtronic, Inc. 710 Medtronic Pkwy Minneapolis, MN 55432- 2. Issuer Name and Ticker or Trading Symbol Medtronic, Inc. (MDT) 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 10/24/2002 5. If Amendment, Date of Original (Month/Day/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Senior Vice President & Chief Information Officer 7. Individual or Joint/Group Filing (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person TABLE I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
+---------------------------------+----------+-------------+-----------------------------+----------------+-----------+------------+ |1. Title of Security |2. Trans- |3. Trans- |4. Securities Acquired (A) |5. Amount of |6. Owner- |7. Nature | | | action | action | or Disposed of (D) | Securities | ship | of In- | | | Date | Code | | Beneficially | Form: | direct | | | | | | Owned at | Direct | Bene- | | | (Month/ | | | End of | (D) or | ficial | | | Day/ +-------+-----+-----------+------+----------+ Month | Indirect| Owner- | | | Year) |Code |V |Amount |A/D |Price | | (I) | ship | +---------------------------------+----------+-------+-----+-----------+------+----------+----------------+-----------+------------+ Common Stock 21089 D Common Stock 140.169 I By 401(k) Plan Common Stock 223.332 I By ESOP
TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
+-------------+--------+----------+---------+-----------+---------------------+----------------+----------+--------+-------+-------+ |1. |2. |3. |4. |5. |6. |7. |8. |9. |10. |11. | | | | | | | | | |Number |Owner- | | | | | | | | | | |of |ship | | | | | | | | | | |Deriv- |Form of| | | | | | | | |Title and Amount| |ative |Deriv- | | | | | | | | |of Underlying | |Secur- |ative |Nature | | |Conver- | | |Number of | |Securities | |ities |Secur- |of | | |sion or | | |Derivative |Date Exercisable +-------+--------+ |Benefi- |ity: |In- | | |Exercise| | |Securities |and Expiration Date | |Amount | |cially |Direct |direct | | |Price of|Transac- |Transac- |Acquired(A)|(Month/Day/Year) | |or | |Owned |(D) or |Bene- | |Title of |Deriv- |tion Date |tion Code|Disposed(D)+----------+----------+ |Number |Price of |at End |In- |ficial | |Derivative |ative |(Month/ +------+--+-----+-----+Date Exer-|Expira- | |of |Derivative|of |direct |Owner- | |Security |Security|Day/Year) |Code |V |(A) |(D) |cisable |tion Date |Title |Shares |Security |Month |(I) |ship | +-------------+--------+----------+------+--+-----+-----+----------+----------+-------+--------+----------+--------+-------+-------+ Stock Options $44.87 10/24/2002 A 44574 10/24/2003 10/24/2012 Common 44574 $0.0000 44574 D (Right to buy) Stock Explanation of Responses: These options become exercisable at the rate of 25% of the shares granted per year beginning on the first anniversary of grant.
SIGNATURE OF REPORTING PERSON /s/ Carol E. Malkinson, Attorney-in-fact __________________________ Jeffrey Balagna DATE 10/25/2002 EX-24 3 balagnapoa.txt JEFFREY BALAGNA POWER OF ATTORNEY Power of Attorney I, Jeffrey A. Balagna, 710 Medtronic Parkway, Minneapolis, MN 55432-5604 do hereby appoint: David J. Scott, Senior Vice President, General Counsel and Corporate Secretary Medtronic, Inc., 710 Medtronic Parkway, Minneapolis, MN 55432-5604 Richard F. Hamm, Jr., Vice President and Deputy General Counsel, Medtronic, Inc., 710 Medtronic Parkway, Minneapolis, MN 55432-5604 Gary A. Nelson, Vice President, Risk Management and Legal Administrative Services Medtronic, Inc., 710 Medtronic Parkway, Minneapolis, MN 55432-5604 Carol E. Malkinson, Senior Legal Counsel and Assistant Secretary Medtronic, Inc. 710 Medtronic Parkway, Minneapolis, MN 55432- 5604 As attorney-in-fact in my name, place and stead to act individually in any way which I myself could do, if I were personally present, with respect to the filing of reports as required under Section 16(a) of the Securities Exchange Act of 1934, including Forms 3, 4 and 5, and under Rule 144 of the Securities Act of 1933. In Witness Whereof, I have hereunder set my name this 29 day of August, 2002. /s/Jeffrey A. Balagna Jeffrey A. Balagna Specimen Signature of Attorney(s)-in-Fact /s/David J. Scott David J. Scott /s/Richard F. Hamm, Jr. Richard F. Hamm, Jr. /s/Gary A. Nelson Gary A. Nelson /s/Carol E. Malkinson Carol E. Malkinson STATE OF MINNESOTA ) COUNTY OF ANOKA ) The foregoing instrument was acknowledged before me this 29 day of August, 2002. /s/Sonja S. Bornus Sonja S. Bornus -----END PRIVACY-ENHANCED MESSAGE-----